Loading...
HomeMy WebLinkAbout026-1115-60-000 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER O.-Y` 1(1~ c~1S \ Y`y.C \ vr~ ADDRESS 1.5 O 5 s Mu lqq& d . ~Pcj-o'! , " 'C, /V -K- . ,p SUBDIVISION / CSM# L~ 11~ I4SLA &aA&u.A LOT 9. 4-n SECTION. T 36 N-R__ZYW, Town of Cam` 41;1 1 . ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WIT N 100 FEET OF SYSTEM 0 r b1 5CA r ~C d a INDICATE NORTH ARROW Provide setback and elevation information on reverse of Provide 2 dimensions to center of septic tank manhole cover. t ~ I BENCHMARK : (lo e r /00 ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING -TANK INFORMATION r 7.5 Manufacturer: Liquid capacity: ,05r A Setback from: Well House Other Pump: Manufacturer o (d Y 6311 Model# 03// Size G~ X60 Float seperation / Gallons/cycle: Alarm Location 64.1 {9 :SOIL ABSORPTION SYSTEM Width: 7 Length /S Number of es -3 Distance & Direction to nearest prop. line: i -Z~ wi-oN Setback from: well: /V14 House So; Other ELEVATIONS Building Sewer ST Inlet; Y 7,5 7 ST outlet g~ .9 y ~A PC bottom 3 'S Pump Off PC inlet cV6 cC Header/Manifold C? 4, Bottom of system g , 7 Existing Grade_ Final grade / . DATE OF INSTALLATION: / PLUMBER ON JOB: LICENSE NUMBER: S 6__:~ INSPECTOR: )t4ia 7~~ 3/93:jt (J u 's 's part~~+St y. 01.30.18-ARA XVRG@:kVSTEM County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division (ATTACH TO PERMIT) 5anitar rtni GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State P Ins Parcel Tax No.: CST BM E►ev.: p. ev.: BM Descriptio TANK INFORMATION ELEVATION DATA A9300161 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV_ Septic Benchmark Dosing Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Verit irIto ntake ROAD Dt Inlet TANK TO P / L WELL BLDG. A Air Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Forcemain Length JDia. H Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION TypeO CHAMBER Mode Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: RICHMOND 01.30.18.668 (CTY RD GG) Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05191) Date Inspector's Signature Cert. No. t ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION 7DILHR In accord with ILHR 83.05, Wis. Adm. Code co 'UNTY STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ c~ ,8% x 11 inches in size. k ev sio o pr wus application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER1 PROPERTY LOCATION tee, r r t G t< Ctr 4- v~.C. I 5,a% /1/W% S T 30, N, R Ik r) W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 1.56.5 ?qwy &.5 A0 I CI ST E ZIP CODE PHONE NUMBER SUBDIVISI N NAME CSM NUMBER tc.~merrclW SYof 7 (S asJb 'IS~r 01"e )s II. TYPE OF BUILDING: (Check one) El State Owned ❑ VILLLLAGE NEAREST ROAD` 1 N1 In c_- l C9 ❑Public or2Fam.Dwelling4ofbedrooms PARCEL TAXN ( III. BUILDING USE: (If building type is public, check all that apply) (o d 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. P New 2. ❑ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION ioOD /,;Zoo $ 5 9s-j3 Feet 9%-S Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank .%So Lift Pump Tank/Si hon Chamber :3~__17501 W Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name ( mt): Plumber's Signa (No Stamps) AV/MPRSW No.: Busing Phone Number: a5~6 `5/3S C ~v Ihs r`S ~r. ~~s.~•~.,i-c-~ /5 ~3 7/5 a Plumber's Address (Street, City, State, Zip Code): !9. 4.5 IX. C LINTY/DEPARTMENT USE ONLY ❑ Disapproved SarySBry Permit Fee (includes Groundwater Date Issued suing ent Sign ~~IkAn~ urcharge Fee) 1dt Approved ❑ Owner Given Initial Adv erse Determination I 2f. X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new ! criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfcjx,Per:owal Form (8133 5 6399) to be subpytted to the county prior.to installatipp. v~ 5. Onsi setve?ge systems must be properly maintat,ied. The a I.r teal sY rst be`p%rr,s k7y"a licon~ecl pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code admiinir or the State of Wisconsin( Safety & Buildings Division, 608-266-38.1.5 , To be complete and-accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide"the legal description and parcel tax number(s) of where the system"Irz:#o be installed... IL Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requester in ##1-7. VII. Tank ini'rr)rr:-tation. Fill in the capacity r<f every new and/or eh tank, !st t`ie total uar .rs number of tanks are manufacturer's narne. lndlca prk,Fab or site coast,,,-.t -.rd tank material. (cgirl,;ete: for all septic, purnp/siphon and holding tanks i0 this system. Check o. -;mt,ntal approval only If tanks received experir a;;'ai product approval from DILi-N, VIII Responsibility statement. Installing plumber is to fill in narne, 6cs-ise number with appropriate prefix (e.g. MP, et(;.), address and phone number. PlLnriber must sign __.pp ication fcrm. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specific;afrc~nc. not smaller +'•;ar, ' 11 inches M,=.'# he submitted to the courity. The plans must include the follovair,g plot plan, ;wavy) to kale or with •_o < pry:`-= dimensions,, location of holding t.arik(s), septic tank(s) o° ,:they treatment tanks; building sewe-- wc~ s, water cater service; streams aod lakes: pump or sigh€,r? :auks; distribution boxes; soil abso-Mioo systems; reola~7;-rnert system areas; an.c the location of the bur di r? served; 3) iz,;. tai and refe•(:,:n,,f, u0nts; C) complete specifications for pur+ips and controls; dose volume; ,elevat,un ditierences; Eric,:on loss; pump performance curve; pump model and pump manufa,~turer; D) cross section of the soil absorption system if . t;;equired by`the county; EJ soil test data on a 1f5 Corm; and F) all s E tg'information. N < - - - - - - - - - - - - - - - GROUNDWAT10%-S6RCHARGE 1983 Wisconsin Act 410 included the c(e'atior, of surcharges (fees) fot 3 r}um'.) ;r of regulated practices vfhry ch.. gar; effect Y;oundw or. : \ T.he.rttonles pak{gctet threugh thf'sie S!A;char , i sett fcr mprllCpr.?I rt i] C{~'~t-;` Cp~:CEJ[ u } water contamination investigations and estahhshn..•,-4:i, standards. P SBD-6398 (R.11/88) r " APPLICATION FOR SANITARY PERMIT . STC - 100 his application form is to be completed in full and signdd by the owner(s) of the roperty being developed. Any inadequacies will only result in delays of the permit esuance. Should this development be intended for resale by owner/contractor, ("spec ouse"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property 1 VIL--OW )elvk►Z ~401#47_ V4F1_"rz'urz4e7 ICHOO-EL SA S Location of Property 56 k IC, Section , T 30 N-R_ H Township et C44A40"0 Mailing Address !50 S gy ~S /SEW K t L4404 ONo, Address of Bite 7 0 /LI V jH ST_ NIP~ "A4014'8 q0 -7 Subdiiie-ion Name t-L c7w ly L. ~EA~OC7w5 Lot Number t 1~0 • Previous Owner of Property 67 E227f'L~.I DOE, Mr O Total site of Parcel Date Parcel was Created qa Are all cornets and lot lines identifiable? _ X Yes No Is this property being developed for resale (spec house) ? Yes No volume =r.. and Page Number $(o as recorded with the Register of Deed@.• INCLUDE WIT11 THIS APPLICATION THE FOLLOWING: 'A Wettant Deed hick includes a Document number, volume and page number, and the Seel of the Register of Deeds. In addition, it certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Hap, the Certified Survey Hap shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERUMATiON Id a cvtt i~y that aCC statements opt th,1~s 6ohm ane fi~r.ue to the best o6 my (out) hnewtedgei that I (we) an (OAC) the oauneAki o6 the phopehty deAc i.bed in VUA .tn4onmatton 6oAm, by vixtue 06 a WOkAanty deed neconded .in the 06 ice o6 the County RegiAte~t o6 Oee&m Oocumen.t No. #SSZo(o ; and that I (we) p)teaentty c.un We prtoposed site bolt the 'Sewage CUAPOA eys em (oh i (we) have obtained an eaAement, to Run with the, above d6cAtbed ptopWtf, oh the eonsthuctton o6 &di.d eyetem, and the same heu been duty heeoaded .tn tke ~dtee o6 .the County Regtaten o6 Oted4, as Vvement No. SIGNATURE of OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED nATX STnmvn J1-206 ;)V~IAGE~~~1 REGISYER'S OFFICE Michael R.. Stevens,. William 11., Derrick, , it or. CROIX CO., WI ReC'd for Record William. M.. Derrick, Thomas E. Derrrl.ck. a ..nd Ronald L. Derrick as. tenants-in-common................ Jl1N ~q 1;~~U at 8:30 ~1. M -11111 t,:rrtan!r' I" Willow. River.. J.oint........ . I < a „ Inntl'}g .....Venture Ra0dlAer of deeds ....r........ . . nR1U1tN t0 ......:..............................1....... ' III htllmOm! dc.^•rlih►d rend ealnte fit S.t. xr.oix ...Cottnty, Sl.nle of Maconsin: Tait Itsreel Not II Southeast Quarter of Northwest Quarter "d N Wteast 0"anger of Southwest (juarter of Section It Township 18 West. .i rut 'I I) ~ ~I'hh , ~8.. hb~ Illahth~ldnd 1►rallrrlr. , Iryijr ~;i;►1, ,.I •,a.~ . I (Is) (ir t1oE~ . FNI-r.111,1011 U. tt•nrrilnHeM 1"U"10 .pal and toning ordina>lnaee, easemeht:s bend tdetrictiond df reeords day of Janu ry................ r 9n. `.C... .(SEAL) •~~(grn1,1 Michael n. l3tev, me William M• Uerzic.. ~ , ~ y . .(~,rnl.l III ~,t~~ , !/.•IJ lC l,. Thgrs l; be ck t~ wi l iam:..11..Uer.ri.ck....... t r' r~T ` 1 ' M a RSTf~81i • Au71•Elrt)vrif)ArloN Rd McNt t;iiae gr.J11 ! "r WISCUMS1N "111 et If a Verr~.c k't W 1 ~ am M. Ue tr Thvmn Dart Ck.. an an. d Count). ......rsnnnlly cMln~belnrd-nte lltle .:.............,Iln}' of Roa ~ •,l 10.19 nur11tPn lpt'-fdoll'tIds pe1; . st fir...... ll.8n.uar , .`-t ...............................'..iB.........the above nnntcrl ton ~ . auai tli 11. Rem nq, xis ►.an: I►ii ilinrie srii i ri uAlt n>r wis(;1)Ni7,IN hothorit:ed by 4 700.00, Rio. SlMet.) t? me knott•n to he the person she executed the foreoolnq Itlstrunlent find acknowledge the Rome. rtn9 u►stnutitr_I,r vMs nnArtEn nr ..R~M~NGTQN. l,llW OF):'~tr_~9.............. . . . gud1 7,C11a1p11Um y ~Il'S~O1 i?6. I't►I1IIc ...........(:ounlrl NIs. (FtImInlurra mny I,r mthrlitIrnfed nr nrIttim led•trd. Pooh My 01111nlission In pcrnttntcnt.(if Holt elnle a-116ntittn nre no! Ilecca-Inrc.) dnlet ..........................:.......................1 19.........) "'+mct nl ,oolong "Ir.nlnc In nny rnt•nrlly alnn,hl t}tr••1 n•. rtbrl•+1 hollow Ihrtr rt~ni 6n,•+. ttAnnANt1 n.,rn RtAtl1 11'111 17F M.Mr-ONFI N ~II•Knnain I.H1e1 111"91h t.... 1,... Wiscons:wDepartment of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor aAd Human Relations Divis:on of Safety Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Derrick Construction, Inc. GOVT. LOT SE 1/4 NJ., 1/4,S 1 T30 N,R 18 for) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLO K # SUBD. NAME OR CSM # 1505 Hy, #65 16 n/a Willow River Meadows CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE [SOWN NEAREST ROAD Idew Richmond, WI. 54017 (715) 24f)-2320 Richmond Co. #CZ (New Construction Use Residential / Number of bedrooms 4 [ ] Addition to existing building ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .5 bed, gpd/ft2 . 6 trench, gpd/ft2 Absorption area required 1200 bed, ft2 1000 trench, ft2 Maximum design loading rate ___5_bed, gpd/ft2- trench, gpd/ft2 Recommended infiltration surface elevation(s) 95.73 ft (as referred to site plan benchmark) Additional design / site considerations n/a Parent material outwa.sh plain Flood plain elevation, if applicable n/a ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem us ❑ U as ❑ U 19S ❑ U ®cS ❑ U ❑ S ~0 U ❑ S ] U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 77 77 0-7 10yr3/3 none L. 2/m/gr mv_r c s . m 2 7-15 10yr4/3 none sil. /f/p1 mfr g/w 1/m n/p n/p Ground 3 15-32 10yr4/4 none sil 1/f/sbk mfr g/w 1/ra .2 .3 elev. 99.29 ft. 4 32-84 7.5yr4/4 noen. S1. 2/m/sbk mfr g/w na/ .5 .6 Depth to limiting factor >8 Remarks: Boring # 1 0-6 10yr3/3 none L. 2/m/gr mfr c/s 2/m .5 6 w:. 3 2 2 6-20 10yr4/3 none sil. 1/f/sbk mfr g/w 1/m 2 3 20-57 7.5yr4/4 none sl. 2/m/sbk mvfr g/w 1/f. .5 .6 Ground elev. 4 57-84 10yr5/4 none co.s. 01sg ml 9 14 ,,"1 ` .8 99.13 ft. ' Depth to limiting factor' Remarks: CST Name:-Please Print h Gary L. Steel 715-?.~Fh~ M00 'L Address: 155 00th. Ave., New Aaclanond., WI. 54017 Signature: i Date: CST Number: 6-29-93 cstri 2298 PROPERTYOWNER derrick Construction, dbqt DESCRIPTION REPORT Page''. of - 3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench .:..3.:. 1 0-6 10yr3/3 none L. 2./m/gr mfr c/s /m .5 .6 2 6-13 10yr2/3 none sil. 1/f/p1 mfr g/w /m n/p n/p Ground 3 13-27 10yr4/4 none scl 1/f/sbk mfr g/w 1/m .2 .3 elev. 98.73ft. 4 27-84 7.5yr4/4 none sl. 2/m/sbk mfr na/ /a .5 .6 Depth to limiting factor >84" Remarks: Boring # 1 0-12 1 3/3 L. 2/m/ ,r mfr none g/w 2/m .5 .6 4 2 12-24 10yr4/4 none sil. 11f.1pl mfr g/w 1/m n/p n/p 3 24-30 10yr4/4 none S11- 2///sbk mvfr P,/w /f .5 •'..6 Ground elev. 4 30-60 10yr4/4 none sl. 2/m/sbk mvfr g/w /f_ .5 .6 97.73 ft. ~ 5 60-84 7.5yr4/4 none sl. 2/m/sbk mfi n./a na/ .5 .6 Depth to limiting factor >84„ I Remarks: Boring # 1 0-7 10yr3/3 none L. 2/m/gr mfr c/w /m .5 .6 2 7-16 10yr4/3 none si1.. 1/f/p1 mfr /w 1/m n/p -n 3 16-33 10yr4/4 none scl 1/f/stilt mfr g/w 1/m .2 .3 Ground o~ley 4 33-75 7.5yr4/4 none sl. 2/m/sbk mfr g/w 1/f .5. .6 Depth to 5 75-86 7.5yr4/4 none sJ_. 2/m/sbk mfi pn/a n/a .4 .5 limiting factor >86'1 Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) i STEEL'S SOIL SERVICE t554 200th. Ave-. Gary L. Steel C.S.T. 2298 Derrick Constniction, Inc. New Richmond, WI 54017 MPRSW-3254 SE-,NVT% Sl-T30N-P.1814 (715) 246-6200 town of Ricbmond. lot #16, Willow Fiver Meadows ,9 k SS 19k ti ~y k Np (PO 0coo Cavn steel y . 6-29-93 SC°':'TC "~\^!K uAL:iT1::iA:iC= ~\CZZi:!E:iT S r.. C ro Lz Cu un c'r W/,f-LOW'ekvt-a .Jo/%rr 7u OWN C• :t /'3 U•C 2:Z 1Q ! C44 AeL- 4 5 reyc'i-1-S EtOUTC190: lumBE:: 15os 77Vyy (0S Ftrs lumber CITY/ S" A22 MEW el "4 0A-J 1eC! l ZI° S O/ 7 P^~PE:L2'~ LaG12I0N: 5L ~/uJ Saccioa Z 30 ":own at lC.t-f/~ION~ St. Croix CounC7, evi Lc.o w t L*--'x Subdivision /Llt'zlOOu~.s Lac cumber /b Zmarooer use Xad Maintenance of your septic syscam could result La its premature Failure cc handle wasess. Proper maintenance can- sizes at pumping out Cho Septic tank aver7 three years or sooner, i= aeeded, by a Licensed SeacLc tank auumver. ghat you put Laco the system can ar ac: -::se cuncc:un oc the septic cank as a c=eac- cnene stage ,a the 'Jasea disposal svscam. St. Crot= Caunc-r residents may be aligibla cc receive a grant For a maximum it bdZ at the case it replacement of a Failing syscam, which was La operacion prior Co July L. L478. St. Croix Cuunc7 aecepcad this program La August of L980, viers Cho requiremonc chat owners of all acv svs~z_ agree co kaeo their systems properly maintained. .%e ?rooer_7 owner agrees co Submic co Sc- Cr01.» CJunt7 Zaniag a car:i.ieacion Eorm, signed by the owner and by a mas.ear plumber, journeyman plumber, restricted plumber or a Licensed pumper vert- l7taq chat (L) cue on-site wasc*vacar disposal system is : Ln prooei operacing condition and (Z) ac':ar LascoccLon• and pumoLag. (i! aec- essary), che•seacic cank Ls Less Chan L/3 Full of sludge and scum Carci!icacion Form vfll be sent aooroximacaly 30 days prior cc three year expiration. I1t3E. the undersigned, hare read the above requirements and agree cc maw .cairn case pri•raca sewage disposal system i,a accordance with the scandards sec for_h; herein, as sac by the '.JLseonsin Depart- none ac Vatural Resources. Car`i_°:cacioa gotta must be completed and rec:sraed cc ;he Sc. Croix Councj Zontag OE!Lce within 3`0' days of cite three year expL=-'tion dace. IATIM' Sc. C:a Caunc-r Zanin-4 CE.ics P.U. ton - '?ammonia. .:L ;4(1 j 7 7 42S.10 outlet 07 AM 1 Wi I ' o W ,07,x.. ,s~~ 203 Afflr • e River 16 =,#AM 19~ Meadows J w ?'OLei,~ .t 20 dos Z= Afs99 w 215 A== 14 M 30S 202 AO 20` 13 21 ~J' ►s 215 Af759 2m Aaf. sa ~ w M 1 351.13 9 0 151.13 200 m 253.19 2.01 ACM 2.00 ACM e . Z= AaN 2 « 22 201 AC 2.00 Agin N 205 214 135.29 Xo Public 2M 4M.74 23 N N 2.00 Afi99 N 2.00 AMU N 2.22 Aaf♦ T 199' $ ,6 n 255 205.30 24 5" ov 200 A/ s ? 28 G o.. h 227 Af111M 425.23 eP mr 5 0 31.E - r 25 2A/ AtY9{ « ~ M a 204 b1r 440.49 N N 27 N ~ 9 233 AMU 4 A 77.a O_ 2O AOM a •75.3, 250.57 'AL 3O 77.90 cSy of Now Aif•J mom 3 26 ~ 111 Aff199 2.30 O W p 507.05 " 30 .U 22. 200 211.03 s tos AO" Z 1s County Ad. GG` 3=1.20 32 33 R a' 220 Adfl{ N 126 A91N 2 N 31 « e lil. Aam. « 201 Aw9 w n = . 20040 325.37 2=5 Highway GG ICK (715) 246-23je RoutNew RichmoC O N S T R U C T I O N Wiscon I I L { I~ t _ i _-I I I i 1 II ~ I Itl,~ 11 I I ~ ! I ' I i I { I 1 : 1 I ~ I I ~ I l 134 4 1 I { I I I a I~ I ~1 I I I i... I 1 I I I I ~I I I i I 1 ~ I t I { I E { 1 I I I I ' % 0 I M I I OI I 1 I + 1 I , I ~ I~ ; 1 - - ' I I' i l ' I f ~ I I~ • + I 1 } I ~ I , i ~ I I 1 I I ~ II~ : I . I ! I 1 I ' ' ; . ! ~ i I i I 1~ 'v I : • 1 I I ' ~ I I h I I I ' I ~ I ' j I ' : I I 1_ J - F i ; 1 I I ; I i ~ I~ I I I I i ' I I i I I I I I i --1- i ; I ' I L I f > H ' ' f ~ ~ I ~ I I I 1 I ~ I i i ~ I I ~ I ~ 1 I 1 ! ~ i I 1 I I 1_ i T 1 ~ f ~ t 1 I I I I ~ i I ~ 1 I I t I I I I I I i 1 ' ~ ~ ' I I I G _ I I.-_ 1 1 1 i-- _ I I _ i I I J I I } I ill- - - -I t_. I I I t- r t ? C I ~ I 1 ~ I I t i I _J- , I i I 1_ ' ~ I I I II ~ I I II i L I ' I I I I I I I , I I I I 1 ~ j i iI - ~ I I t i I I I i- t _I_ I I I T-- ~ j j f t I ~I 1 ~ I i I ~ , ' II I I i li I 1 I I I ; I ~ I . I II i ~ I I t I f I I I _ I _ I I I I i- r~ I I I ' I I ' i 7 I ~ I r t 1 f I I I I I I r I I I i I I ~ I 1 + ~ I I 1 I I I t I I ! I I I I I I rt I I PAGE OF ~ SS 5yslun Or Sy 5 r e I t'~ ~ e n y ^n Fresh Air Inlets And Observation Pipe Approved Vent Cap Minimum 12" Above Final Grade 20- 42" Above Pipe _ 4" Cast Iron To Final Grade Vent Pipe Mush Hay Or Synthetic Covering i Min. 2' Aggregate Over Pipe Distribution - Tee pipe 0 0 0 0 0 ! 6` Aggregate o Perforated Pipe Below BeneolA Plpe Coupling Terminallng At Bottom Of System PrpPoSC ~ t'Inwl 1gr~,~1< ~ 99' S .SOIL FILL OISTRIBUTIOI.I PIPE APPROVED SIMHETIC COVER r o e _OK 14t_ op, NA` 11 OF STRAW OF AGGR EGATE 73 1o' OF 12 -Z1~2 AGGREGATE 4:~ ELEV. aF FEF-T f-3 DI-STR15UTIOW PIPE TO BE AT LEAST 20 INCHES BELOW ORI&WAL GRADE AWt) AT LEAST?O WCHES 61JT 1.10 MORE THAM 42 IAICNES BELOW FINAL GRADE MAXIMUM OF-Mi OF EXcAVATiop Rom ORI&WAi WK WILL BE IAICHES MAMUM Wrti OF EACAVATiom FROM t\141WA1L (aR49E WILL BE ,Q _L- INCHES LIGEWSE AJUMBER: 363 DATE_ 7 ~7 y 4 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Lnix_*nnd I tumnn Relations Division of Safety R Buildings in accord with ILHR 83.05, Wis. Adm. Code A . COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Derrick Constniction, Inc. GOVT. LOT SE 1/4 NW 1/4,S 1 T 30 N,R 18 IXor) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLO K # SUED. NAME OR CSM # 1.505 fly. x/65 16 n/a Willow River Meadows CITY, STATE ZIP CODE PHONE NUMPER ❑CITY ❑VILLAGE GOWN NEAREST ROAD New f iefintond, WI. 54017 (715) 24E'-2320 Richmond Co. #CZ LxkNew Construction Use M Residential/ Number of bedrooms 4 [ j Addition to existing building [ I Replacement [ j Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .5 bed, gpd1ft2 . 6 trench, gpolft2 Absorption area required 1200 bed, ft2 1000 trench, ft2 Maximum design loading rate ___5 bed, gpd/ft2___.b trench, gpd/ft2 Recommended infiltration surface elevation(s) 95.73 ft (as referred to site plan benchmark) Additional design / site considerations n /a Paient material outwa.sli plain Flood plain elevation, if applicable n/a It It =Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK = Unsuitable fors stem US ❑ U f4S ❑ U IXS ❑ U E36 ❑ U ❑ S )O U ❑ S )COU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench m 77- 7 7- 7 T7- 1 0-7 10yr3/3 none L. 2 m gr my r c s - - 2 7-1.5 1.0yr4/3 none sil. /f/p1 mfr g/w IN n/p n/p Ground 3 15-32 10yr4/4 none sil 1/f/sbk mfr g/w 1/rrt .2 .3 elev. "9.29 ft. 4 37-84 7.5yr4/4 noen S1. 2/m/sbk mfr g/w na/ .5 .6 Depth to limiting - factor > - i Remarks: Boring # 1 0-6 10yr3/3 none L. 2/m/gr mfr c/s 2/m .5 r6 2 6-20 10yr4/3 none sil. 1/f/sbk mfr g/w 1/m .2 .3 3 20-57 7.5yr4/4 none sl. 2/m/sbk mvfr g/w 1/f. .5 i,.6 Ground - elev. 4 57-04 10yr5/4 none co.s. 0/sg m1 n/a /a. .7 ' .8 00.13 ft. - f , Depth to - limiting factor >8411 Remarks: CST Narne.-Please Print 4 h M Gary_ L.Steel 715-?. ► . - DO Address 15354-200th. Ave. > New P,iclunond> 141. 54017 ^ ''i<< i Date: CST Number; o 6-29-93 cstnt 22c)8 P110PERuvw4fR rle r:r c t Construction, dbqk DESCRIPTION REPORT Page of 3 PARCEL I.'8. # Depth Dominant Color Mottles Structure GPD/ft Roring # I lori7on in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Tteridt 3 1 0-6 10yr3/3 none L. 2../m/nr mfr c/s /m .5 .6 - 2 6-1.3 10yr2/3 none sil. 1/f/pl mfr /w /m n/p n/p Ground 3 13-27 10yr4/4 none scl 1/f-/sbk mfr g/w 1/m .2 .3 elev. 98.73 It. 4 27-84 7.5yr-4/4 none sl. 2/m/sb1c mfr na/ /a .5 .6 Depth to limitiny factor Remarks: Boring # 1. 0-12 10yr3/3 none L. 2/m/gr mfr g/w 2/m .5 .6 4 12-24 10yr4/4 none sil. 1/f./pl mfr g/w 1/m n/p n/P ,11. 2///sblc mvfr /w /f .5 .6 324'-30 10yr4/4 none Ground elev. 4 30-60 10yr4/4 none sl. 2/m/sbk mvfr g/w /f .5 i' .6 07.73 ft. 5 60-84 7.5yr.4/4 none sl. 2/m/sbk mf_i n/a na/ .5 .6 Depth to limiting factor )ftL+„ j Remarks: _ Boring # 1 0-7 10yr3/3 none L. 2/m/gr mfr c/w 2/m .5 !.6 5 7-16 10yr4/3 none sit.. 1/f./pl mfr g/w 1/m n/p/p 3 16-33 10yr4/4 none scZ 1/f/sblc mfr g/w 1/m .2 il3 Ground - le . 4 33-75 7.5 r4 /4 none sl. 2/m/sbk mfr i;/w 1/f .5 .6 tya ft. - Y 5 75-86 7.5yr4/4 none sl. 2/m/sbk mfi gn/a n/a .4 .5 Depth to limiting factor Remarks: Boring # Ground - - - elev. ft. Depth to - - limiting factor Remarks:.__ • r STEEL'S SOIL SERVICE Garr L. ,St(,el 1554 200th. C.S.T. 2298 Derrick Construction., Inc. New Richmond, WI 54017 MPRSW-3254 SEhNW, Sl-T30P?-P.18W (715) 246-6200 town of Richmond lot 1116, willow River Pleadows {l TO i~ k l~0 y h coo U ~A h ►S-~ Gary L. steel 6-29-93 • PAGE OF j PUMP CHAMBER CROSS SECTIOIJ AkJD SPECIFICATIONS I~.~C~~WrTS'r~~ VENT CAP 4"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING 2S' FROM DOOR, JUNCTION BOX MANHOLE COVER WINDOW OR FRESH 12"MILT. AIR INTAKE GRADE I I `i"MIN. L-- IB"MIN• cououlr le"MfN. fAli.. -T PROVIDE I AIRTIGHT SEAL I I I V APPROVED JOINT A I III APPROVED JOINT W/C.I. PIPE. I I W/C:T. PIPE EXTCNDIAIf• 3' I III EXTENDING 3' ONTO SOI.ID SC:;. ALARM i B I ( ONTO SOLID SOI I 1 I I ON I I SI PUMP ` OFF D CONCRETE BLOCK RISER EXIT PERMITI•ED ONLY IF TANK MANUFACTURILR HAS SUCH APPROVAL SPECIFICATIOUS SEPTIC ANp ' DOSE TANKS MANUFACTURER: w-s-'`Q0-^- NUMBER OF DOSES: T PER pA4 TANK CIZE: 75© GALLONS DOSE VOLUME ALARM MANUFACTURER: S ill QC r ysf~,,, INCLUD!!!C, :,%,:!.FLOW: 7.5D GALLONS MODEL QUMBER: ~o ! # w CAPACITIES: A= oZ 3 INCHES OR ~ GALLONS SWITCH TYPE: YEA--L~µ►a{~~ B _ INCHES OR 3 GALLONS PUMP MANUFACTURER: C =-INCHES OR 16~ CALLOUS MODEL NUMBER' _ .3_ F _ .J C Iq P D ~ Q~ p ~ L --sL--INCHES OR ~ GALLONS SWITCH TYPE: - T NOTE: PUMP AND ALARM ARE TO BE PUMP DISCHAR`E RATE 7 5 GPM INSTALLED ON SEPARATE CIIRCUITS VERTICAL DIFFERENCE B~'WEEN PUMP OFF AND DISTRIBUTION PIPE.. FEET a 0,5~/(M + MINIMUM NETWORK SUPPLY PRESSURE , , , , , , FEET 6 "sO ' FEET OF FORCE MAIN X F j ' iooiT.FRICTIOU FACTOR., -l FEET TOTAL DYNAMIC. HEAD - FEET IIJTERIJAL RIMEIJSIGNC OF TAA1K: LENGTH =f-~ ~ LIQUID DEPT H SIGIc]E D: LICEIJSE NUMBER: - ~-S6 3 ,-'~f DATE: ---,c--+ -11~- a 1 a• lip, GOULDS ,SUB.MERSIBLE • .A - SEWAGE* AND EFFLUENT PUMPS EP0311 LISP DISC. ' rgi~(<xi`y1~4 L} .t 0OUPEP0311 142 YF0311 1/3 HP 115 v effluent IMP 1/2" solids 256.80 172.10 F N tr.l [*otit Submersible r~o~'• J `EfflUeCit t Jk, MODEL EP0311 4 Pump. rya (w ti : 7 ,4 t1 t- + ;t j4MR25FEET SIZE SOLIDS ' r ex rrC 4 20 ,YeY y~. 15 a 1~.:, 1nR. fa„ 10 fi, K 0 ,V( 2 0 00 4 8 12 16 20 24- 28 32 38 40 L CPU 0 2.5 5.0 7.5 m'/h CAPACITY , V1 lt: Performance Curve 3885 MODEL 3885 00 SIZE 1/4' Solids 10. 70 4z11~( ,ti s . py . ,o ~Ui WEOM- :t YJ 16- y - wcos++ 40 ' wF r,l , ,0 30 WWI, s C Nz~ '1ry~ t o 0 ;Y.?:,• ~•k:'~ ..1'.'~c` o ,a 20 00 .o co in 70 ao ou ,oo no ,ao ovu 0, to 20 X.H. CAPACITY LIST DISC. r x', OOLAVE0311J. 142 WF0311L 1/3 HP 115 V Low H 3/4' solids 491.55 329.35 yTttr.., ~ t % r 4lr•° QOt.'Pt+'E0311M 142 ' WE0311M 1/3 HP 115 V tbd H 3/4" solids 491 .55 329.35 >7~ y~ Z4 3 oalpimsIIli 142 WE0511H .1/2 IT 115 V Hlah H 3/4" Solids 704.25 471.85 r 17( t 4;; UJ<)RdE071211 142 ti107121i 3/4 HP 230 V High M. 3/4" solids 843.65 565.25 ( ~xs~ SFE`.FC l-,CWIP, PAGE FM PE(t1CftAiA AND SPECIFICATIONS, `1]+~TE 10/88 DE T 30 PACE Vu ''1.